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Director Discusses Innovations in ‘Invisible Wounds’ Treatment

By Terri Moon CronkAmerican Forces Press Service

WASHINGTON, Sept. 13, 2013  The Military Health System acknowledges that U.S. troops in previous conflicts haven’t been subjected to the circumstances that surround 12 years of war in Iraq and Afghanistan, a senior Defense Department physician said here yesterday during a panel discussion at a warrior-family symposium.

Dr. James Kelly, director of the Defense Department’s National Intrepid Center of Excellence, talked about his center’s advancements in post-traumatic stress disorder and traumatic brain injury – signature wounds from the wars - in a panel discussion titled, “Innovative Mental Health Solutions – Today and Tomorrow.”

The annual symposium is sponsored by the Military Officers Association of America and the National Defense Industrial Association.

Kelly cited problems that stem from the pattern of repeated deployments and training between deployments, combined with an all-volunteer force composed of members put themselves in harm’s way time and time again. “It is not the pattern we’ve previously had in our military,” he said.

The idea that the younger generation is somehow softer or in some ways more vulnerable doesn’t hold water, Kelly said. “These people are tough as nails,” he said to a round of applause from hundreds of audience members.

“What we need to do is innovate, look more in depth, and understand them as people and individuals that have been engaged in ways [for which] we simply have no good track record to point to and say, ‘Here’s what this is about, and here’s what to do about it,’” he said.

Kelly said he and his staff learn as they go at the center, conducting research and treating service members in an intensive four-week program.

In a previous interview with American Forces Press Service, Kelly explained that when service members with severe traumatic brain injury do not respond to conventional medical treatment, they can be referred to the National Intrepid Center of Excellence, but they must also have a co-existing psychological health issue, such as post-traumatic stress disorder, depression or anxiety.

Kelly became NICoE’s director five years ago. The center got underway when Defense Department officials invited him -- a former neurology consultant for the Chicago Bears football team -- to join a group of doctors to examine how to treat service members who were exposed to blast injuries and other head trauma.

He and the other doctors were “willing volunteers” drawn to military health care and working with service members coming back from both wars because of blast-related injuries and a variety of other causes of concussions, Kelly said.

The need for innovation in research and in treating service members led to a concept of using “virtual reality war,” with service members are immersed in a setting with a vision of what happens when they’re inside a Humvee going down a road. The seat begins to vibrate as a bomb goes off, and the smell of burning rubber wafts into the vehicle. The hope, Kelly explained, is that while the service members are in a safe clinic setting, the experience can help them get past the traumatic events they brought back from deployments.

This use of virtual reality shows quantifiable metabolic changes deep inside the brain when it’s dealing with stress, Kelly said.

“That’s just one of the examples of the kinds of things that we’re engaged in that is really novel, innovative,” he added. “[It] bridges into areas of the mind … in ways that traditional medicine -- certainly traditional neurology -- hadn’t previously.”